scholarly journals Outcome of cerebral contusion in mild traumatic head injury patients

2019 ◽  
Vol 6 (11) ◽  
pp. 4032
Author(s):  
Jagadish B. Hedawoo ◽  
Maheshkumar S. Soni
Keyword(s):  
Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Traumatic Head Injury ◽  
Cerebral Contusion ◽  
Mild Tbi ◽  
Tertiary Centre ◽  
Traumatic Head ◽  
Ct Brain ◽  
Gcs Score

Background: Mild traumatic head injury is classified as one with Glasgow coma scale (GCS) score between 13 and 15. The aim of the study was to find underlying cause of deterioration of mild traumatic brain injury (TBI) and its association with other factors like bony injury.Methods: A prospective observational study at a tertiary centre with patients admitted for mild TBI with GCS 13-15 were followed up in ward and reviewed after every 6 hours interval, those who deteriorated repeat computed tomography (CT) scan was done for further diagnosis and intervention.Results: Determining the level of deterioration after 24 hours observation following mild TBI, 268 (63.4%) of the admitted patients were discharged home after 24 hours of observation, 89 (20.7%) needed more observation while 63 (14.8%) deteriorated and 3 (0.7%) died. As the GCS on admission was decreasing; deterioration increased i.e., 12.7%, 16.7% and 33.3% for GCS of 15, 14 and 13 respectively. Likewise, as the GCS increased, recovery improved. Subdural haematoma (39.7%) was the leading cause of deterioration while (13.8%) despite their deterioration, CT brain did not reveal any abnormality.Conclusions: Patients presenting with mild TBI (i.e., GCS- 13-15) secondary to high velocity/energy trauma i.e., road traffic accidents have to be carefully observed for at least 24-48 hours post-trauma as the chances for neurological deterioration are significant especially in polytrauma patients. The most cause for deterioration is subdural haemorrhage among others, has to be investigated so appropriate management for the same can be instituted as soon as possible. 

scholarly journals The estimated cost of surgically managed isolated traumatic head injury secondary to road traffic accidents

2018 ◽  
Vol 44 (5) ◽  
pp. E7 ◽  
Author(s):  
Xinli You ◽  
Boon S. Liew ◽  
Azmin K. Rosman ◽  
Kamarul Imran Musa ◽  
Zamzuri Idris ◽  
...  
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Cost Of Care ◽  
Road Traffic Accidents ◽  
Traumatic Head Injury ◽  
Traumatic Head ◽  
The Mean ◽  
Mean Cost

OBJECTIVETraumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury.METHODSRelevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452.RESULTSThis costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1–3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05).CONCLUSIONSThe mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.

scholarly journals Etiological Factors of Extradural Haematoma: Experience of 80 Cases in Bangladesh

2017 ◽  
Vol 14 (2) ◽  
pp. 44-48
Author(s):  
Md. Abdus Salam ◽  
Md. Shafiul Alam ◽  
Kalim Uddin ◽  
Md. Ashraful Haque ◽  
Md. Mahfuzur Rahman ◽  
...  
Keyword(s):  
Head Injury ◽  
Road Traffic ◽  
Cross Sectional Study ◽  
Extradural Haematoma ◽  
Age Group ◽  
Traumatic Head Injury ◽  
College Hospital ◽  
Cross Sectional ◽  
Etiological Factors ◽  
Traumatic Head

Background: Extradural haematoma is due to different etiologies.Objectives: The purpose of the present study was to see the etiological factors of extradural haematoma.Methodology: This cross sectional study was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2010 to June 2011 for a period of one year and half months. All patients who underwent surgery with traumatic head injury having extradural haematoma were included in the study. At admission, a detailed history of the illness was taken from the patients/patient’s attendants by face-to-face interview with the help of a preformed questionnaire. Questionnaire was prepared with key variables like age, sex and mode of injury.Result: Eighty (80) patients of traumatic head injury within and after 24 hours of head injury were enrolled in this study. 20(25.1%) patients were present in age group of 11 to 20 years. 19(23.8%) patients were in age group of 21-30 years. 20(25.1%) patients were present in age group of 31 to 40 years. Male was predominant than female which was 60(75.0%) cases and 20(25.0%) cases respectively. The most common mode of injury was road traffic accident which was 51(63.7%) cases followed by fall from height and assault which were 16(20.0%) cases and 13(16.3%) cases respectively.Conclusion: In conclusion RTA is the most common cause of extradural haematoma.Journal of Science Foundation, July 2016;14(2):44-48

scholarly journals Investigating the Association between Orthopedic Fractures and Head Injury due to Road Traffic Accidents

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Mubarak Ali Algahtany
Keyword(s):  
Head Injury ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Traumatic Head Injury ◽  
Chi Square ◽  
Duration Of Hospital Stay ◽  
Orthopedic Injury ◽  
Tertiary Center

Background. Traumatic head injury (THI) due to road traffic accidents (RTAs) is a global health problem. Studies exploring the association between RTA-related THI and concurrent orthopedic fractures are lacking. We aim to provide a detailed analysis of this association and its impact on inhospital outcomes. Methods. Retrospective analysis of RTA-related THI associated with orthopedic fractures admitted to a large tertiary center, Southwest, Saudi Arabia, over ten years. Descriptive statistics for participant demographics and clinical outcomes were represented by percentages. The associations between head injury diagnosis or orthopedic fractures region and patient demographics are analyzed using the Chi-square test. Post hoc analysis for the significant Chi-square values was carried out by calculating the significant adjusted residuals. Adjust p value was obtained by using the Benjamini-Hochberg procedure to control for multiplicity testing. A p value less than 0.05 was considered statistically significant. Results. Concurrent orthopedic fractures are present in one-tenth of RTA-related THI. The cohort was dominated by young males, with 46.5% of the population between 18 and 29 years old. There was a significant association between the head injury diagnosis and the region of orthopedic fracture ( p = 0.028 ). The type of head injury had significant associations with mortality and duration of hospital stay ( p = 0.039 and p = 0.037 , respectively). The region of orthopedic fracture significantly ( p = 0.018 ) affected the duration of hospital stay, with fractures in the clavicle/shoulder region significantly ( p = 0.035 ) having a short course of hospital admission. Conclusion. Orthopedic fractures concomitant with RTA-related THI are common. The associations between the two injuries tend to happen in specific patterns. The inhospital stay duration and mortality significantly correlated with the site of the head or orthopedic injury. Knowledge of these patterns improves the care of THI victims, triaging, and resource allocations.

scholarly journals Assessing the effectiveness of the full outline of unresponsiveness scale and the Glasgow coma scale in patients of traumatic head injury

2021 ◽  
Vol 8 (12) ◽  
pp. 3583
Author(s):  
Fahad Ansari ◽  
Arvind Rai
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Youden Index ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Medical College ◽  
Traumatic Head ◽  
Four Score ◽  
Gandhi Medical College ◽  
Gcs Score

Background: The Glasgow coma scale (GCS) is the most commonly used scale while the full outline of unresponsiveness (FOUR) score is a new validated coma scale in the evaluation of the level of consciousness in head injury patients. The aim of the study was to compare and assess the effectiveness of the FOUR score and the GCS in patients of traumatic head injury.Methods: This was a prospective observational study conducted in the department of surgery, Gandhi medical college, Bhopal during a 2 year period in which 100 patients of traumatic head injury were evaluated. The FOUR score and GCS score of these patients were assessed on admission and outcome followed for 2 weeks.Results: The mean age group of 100 patients was 25-45 years with 79% male and 21% female patients. The FOUR scale was found to have a marginally higher sensitivity of 65.6% while the GCS had a sensitivity of 64.2%. The FOUR scale however had a higher specificity of 71.5% compared to 66.4% of GCS. The Youden index showed that FOUR scale (46%) has a better prediction for death than GCS (35%). FOUR had a higher accuracy of 75% than GCS with an accuracy of 65%.Conclusions: Both FOUR score and GCS are valuable scales in assessment of traumatic head injury. The FOUR scale however is more accurate than the GCS in predicting outcome of head injury patients. 

scholarly journals Study of cases of head injury in a government hospital in rural Indian setting

2018 ◽  
Vol 5 (10) ◽  
pp. 3252
Author(s):  
Vinod Pusdekar ◽  
Sandeep Ambedkar ◽  
Ritesh Bodade
Keyword(s):  
Head Injury ◽  
Ct Scan ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Government Hospital ◽  
History Of ◽  
Gcs Score

Background: Head injury can be defined as trauma in which the head is struck or moves violently, resulting in transient or permanent alteration of consciousness of an individual. We profiled and analyzed the cases of head injuries reporting to a government hospital a rural Indian setting.Methods: All the patients with history of antecedent head injury were firstly assessed by detailed history, with emphasis on history of unconsciousness/vomiting/convulsions/ENT bleed. Then a thorough clinical examination was undertaken, including Glasgow Coma Scale (GCS) scoring. Further, all the patients were subjected to CT scan of head for correlation of clinical findings, confirmation of diagnosis, delineation of extent of disease and suitability of operative intervention etc.Results: Majority of the patients belonged to 15-44 years age group (30, 60%) and were males (38, 76%). Road traffic accidents accounted for majority (38, 76%) of the cases. GCS score was found to range between 13-15 (mild) in 18 (36%) patients, 9-12 (moderate) in 21 (42%) patients and 3-8 (severe) in 11 (22%) patients. Best recovery (88%) was shown by patients of GCS score between 13-15. Among the critical symptoms and signs, unconsciousness and abnormal plantar reflex were the commonest ones. Generalized cerebral edema without associated lesion (50%) was the commonest finding followed by extradural hematoma (EDH) (40%) on CT scan of head. As for recovery w.r.t. CT scan findings, highest rate of recovery (100%) was reported in patients with fracture without intracranial pathology, while highest mortality was reported in those having mixed lesion (90%).Conclusions: Road traffic accidents in young age group is the commonest mode of head injury and GCS score is a good predictor of recovery in head injury cases.

scholarly journals Secular Trend, Seasonal Variation, Epidemiological Pattern, and Outcome of Traumatic Head Injuries Due to Road Traffic Accidents in Aseer, Saudi Arabia

2021 ◽  
Vol 18 (12) ◽  
pp. 6623
Author(s):  
Mubarak Ali Algahtany
Keyword(s):  
Saudi Arabia ◽  
Seasonal Variation ◽  
Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Skull Fracture ◽  
Road Traffic Accidents ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Traumatic Head

Road traffic accidents (RTAs) are a leading cause of traumatic head injury (THI) and are regarded as a public health problem in Saudi Arabia. This hospital-based retrospective study aims to provide data on the frequency, type, and distribution of RTA-related THIs over the past decade; demonstrate their time trend and seasonality; and decipher age and sex differences in RTA-related THIs and their outcome. The results showed a decline in the number of RTA-related THIs between 2010 and 2019. The patients had a mean age of 26.16 ± 16.27 years, and the male-to-female ratio was 10.8:1. Head injury with multiple lesions was the most common diagnosis, followed by cerebral contusion and skull fracture (32.1%, 12.9%, and 11.2%, respectively). Subdural hematoma (SDH) and skull fracture were significantly more common in patients aged ≥60 years (standard residual > 1.96), and significantly less common in those aged ≤17 years (standard residual < 1.96), compared to other age groups. Males experienced significantly more SDHs than females (standard residual = −2.8, p = 0.029). The length of hospital stay was positively correlated with age (Spearman’s rho = 0.057, p = 0.046). No seasonal variation was found.

scholarly journals Post-Traumatic Hydrocephalus - A Retrospective Study

2021 ◽  
Vol 10 (40) ◽  
pp. 3511-3514
Author(s):  
Srinivas R. ◽  
Davuluri Venkata Shashank ◽  
Mohamed Mohamed
Keyword(s):  
Retrospective Study ◽  
Head Injury ◽  
Tertiary Care ◽  
Traumatic Head Injury ◽  
Medical College ◽  
Traumatic Head ◽  
Post Traumatic ◽  
Trauma Ct ◽  
Gcs Score ◽  
Early Diagnose

BACKGROUND Post-traumatic hydrocephalus (PTH) can occur as an outcome of moderate and severe traumatic head injury. It is one of the causes of delayed worsening of the early symptoms of head injury. A total of 18 cases of PTH diagnosed and treated at tertiary care hospitals from 2012 to 2015 were studied. The purpose of the study was to evaluate the clinicoradiological profile of patients diagnosed with posttraumatic hydrocephalus and determine the outcome of ventriculoperitoneal (VP) shunting in cases of post-traumatic hydrocephalus. METHODS A retrospective study was conducted in the Department of Neurosurgery in a teaching medical college. The clinicoradiological profile of patients diagnosed with PTH was studied. These cases were treated conservatively as well as by surgery. The demography, cause of trauma, GCS score and response rates were studied. RESULTS Among the 18 reviewed patients, 61.1 % were males, fall and RTA constituted the major cause of trauma. Craniotomy was done in 50 % of the patients, 88.89 % of the patients recovered and the mortality rate was 11.11 %. CONCLUSIONS Post-traumatic hydrocephalus is a consequence of traumatic head injury and can occur with various neurological symptoms after the initial trauma. CT scan of the brain is considered the choice of investigation to early diagnose PTH and the patient outcome after VP shunting is good. KEY WORDS Hydrocephalus, Head Injury, Trauma

scholarly journals Outcome of traumatic head injury in unknown patients

2018 ◽  
Vol 5 (2) ◽  
pp. 633
Author(s):  
Ankit Ahuja ◽  
Siddhartha Verma ◽  
Aditya Narayan Chaudhary
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Injuries ◽  
Traumatic Head Injury ◽  
Organ Systems ◽  
Traumatic Head ◽  
Gcs Score ◽  
Discharge From Hospital ◽  
Time Of Admission

Background: Traumatic brain injury is the most common cause of death in trauma victims accounting for about half of deaths at the accident site. Most commonly, traumatic brain injury occurs in the presence of additional injuries to other major organ systems, but it can also occur in isolation. Complications from closed head injuries are the single largest cause of morbidity and mortality in patients who reach the hospital alive. The objective of this study was to determine the outcome of traumatic head injury in patients admitted in the Department of Neurosurgery as unknown.Methods: All patients admitted as “unknown” to Neurosurgery department with traumatic head injury were studied retrospectively. Data was collected regarding demography, mode of injury, clinical presentation at the time of admission, management and outcome of these patients.Results: Data pertaining to 107 unknown patients were collected. Most patients were found to be males in 3rd decade of their lives with vehicular accidents as the common mode of injury. Patients presenting with Glasgow coma scale (GCS) score <8 at the time of admission had poor outcome and associated with higher mortality. Intra-cranial hemorrhage were predominantly found on CT scan. Only one-third of the patients were discharged after treatment while half of them suffered untimely death.Conclusions: Outcome of these neglected patients is poorer in comparison to patients who are accompanied by their relatives. Their management from pre-hospital to treatment and discharge from hospital is fraught with challenges. They need special care from trained nursing staff as well as help from social workers for recovery and rehabilitation.

scholarly journals Comparison between FOUR score and GCS in assessing patients with traumatic head injury: a tertiary centre study

2017 ◽  
Vol 4 (2) ◽  
pp. 656 ◽  
Author(s):  
Sharath S. Nair ◽  
Anilkumar Surendran ◽  
Rajmohan B. Prabhakar ◽  
Meer M. Chisthi
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Head Injuries ◽  
Neurological Status ◽  
Initial Assessment ◽  
Traumatic Head Injury ◽  
Mortality And Morbidity ◽  
Coma Scale ◽  
Tertiary Centre ◽  
Traumatic Head

Background: Head injuries are a major cause of mortality and morbidity across the world. Effective initial assessment and early intervention is of importance in patients with traumatic brain injury, so as to ensure the maximum favorable outcome. Glasgow Coma Scale is the widely accepted scale to assess severity in head injury patients, albeit with many inadequacies. The objective of this study was to test the validity of full outline of unresponsiveness score, an alternate tool, in assessing severity in patients with traumatic brain injury.Methods: This was a descriptive study, conducted on 69 patients admitted to the general surgical and neuro-surgical wards of Government Medical College, Trivandrum, India with traumatic head injury. For all these patients, full outline of unresponsiveness score and Glasgow Coma Scale were calculated at the time of presentation and serially thereafter. The predictive value of full outline of unresponsiveness score as well as its correlation with Glasgow Coma Scale was studied.Results: A statistically significant correlation was found between full outline of unresponsiveness score and Glasgow Coma Scale in estimating the severity of head injury. Also Full Outline of unresponsiveness score was able to furnish better details about the neurological status of trauma patients.Conclusions: As per the results, it can be concluded that the full outline of unresponsiveness score can be applied as an ideal tool to evaluate consciousness levels and patients’ status in patients with traumatic head injury. It can be used as the ideal replacement for Glasgow Coma Scale.

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